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<br />r- t/ (i6 s7 <br /> <br />c/t..JcJ <br /> <br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />ADDRESS <br /> <br /> <br />i,etll/l! <;7111 / /JI. <br />~cJlZtJd7V ,y: <br />//! ,#tf// IV . . ~ 1/7/. <br />rt p? ~cJlZ()tfN S'p. <br />;y3 <br /> <br /> <br />~;V: tNCAP- <br />.~ Vl_ -() / ./) 0 <br />pHONE / 0- C/ ..:s <br /> <br />APPLICANT <br /> <br />'. <br /> <br />t tm J,lf <br />Ik~r <br /> <br />/ <br /> <br />BLOCK <br /> <br />, ", uj~ ; <br />Lo'T S!.ZE~X 7~"'" AREA SQ,FT. <br />tJIA1/?,LJ <br /> <br />SUBDIVISION <br /> <br />OWNER <br /> <br />JOB LOCATION <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />PARCEL 1. D. 4~ <br />WORK PROPOSED:~New Construction ____Addition ____Alteration <br /> <br />_Repair <br /> <br />____Install <br /> <br />____Sign/Temp, <br /> <br />____Sign <br /> <br />_Hove <br /> <br />____Demolish <br /> <br />PROPOSED USE: ~Single Family <br /> <br />~/F <br /> <br />____t~ of Uni ts <br /> <br />, .____M / H <br /> <br />____Commercial <br /> <br />____Indust, <br /> <br />_Swim. Pool <br /> <br />Other <br /> <br />____Restaurant & Health Department Approval <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COMMERCIAL : <br /> <br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS,** <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.H <br />**COPY OF CONTRACT REQUIRED, <br /> <br />~ERMITS REQUESTED <br /> <br />LBUILDING <br />_ELECTRICAL <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />AMP Service <br /> <br />_Florida Power Corp. <br /> <br />_W,R,E.C, <br /> <br />_MECHANICAL <br /> <br />$ <br /> <br />_Valuation of Mechanical Installation <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />RUOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block ____Frame _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: FT, <br /> <br />( ;1 ..................................***...., <br />Let IV~ CONTRACTOR SECTION nA1..uL <br />. Company /~'Iv~ <br />State Cert, or Regist. Q <br />Signature City License Registration j~ <br />******************************** <br /> <br /> <br />1/'7" <br />I~ <br /> <br />ET,ECTRICT AN Company <br />State Cert, or Regist. Q <br />Signature City License Registration U <br />****************************************** <br /> <br />PLUMBER Company <br />State Cert, or Regist. n <br />Signature City License Registration j~ <br />****************************************** <br /> <br />MECHANICAl. Company <br />State Cert. or Regist. # <br />Signature City License Registration iF <br />****************************************** <br /> <br />OTHER Company <br />State Cert, or Regist. 0 <br />Signature City Li.~ense Registration iF <br /> <br />APPLICATION APPROVED BY PERMIT OFFICER. <br /> <br />